Automatic association of medical elements

ABSTRACT

A system and method of associating a plurality of objects is disclosed. A physical space is defined and a real-time locating system (RTLS) is used to determine objects that are within the physical space. The objects determined by the RTLS to be within the physical space are associated. The objects include at least one of a caregiver, a patient, a medical device, a medication, and a medical substance.

BACKGROUND

1. Field

The present disclosure generally relates to systems and methods ofidentifying the location of people and equipment, and, in particular,relates to the automatic association of medical equipment with proximatecaregivers and patients.

2. Description of the Related Art

A commonly followed procedure to ensure the safety of patients beingtreated in hospitals has been the establishment of the “five rights” ofmedication administration. These are (1) right patient, (2) right time,(3) right medication, (4) right route of administration, and (5) rightdose. For a medication administered via an intravenous (IV) pump, forexample, it requires care and attention by the nurse or other caregiverto ensure that the medication matches the patient and that it isadministered at the proper flow rate and the proper time. Patients alsomay receive treatment involving a medical substance other than amedication, e.g. a “normal saline” solution (9 grams of sodium chloride(NaCl) dissolved in 1 liter of water) administered as an infusion totreat dehydration. Maintaining the required level of attention to ensurethat medications and medical substances are properly administered can bea challenge in the hectic environment of a hospital.

Automated processes have been increasingly implemented to reduce thepotential for human error. Scanning a barcode that is printed on awristband worn by a patient, for example, ensures that the patient iscorrectly identified. This type of process, however, often carries apenalty of increased complexity of the process wherein the nurse mustmanually scan one or more barcodes, which also increases the amount oftime required for the nurse to complete a procedure.

SUMMARY

In order to improve the safety of the patient while simultaneouslyeliminating at least some of the time-consuming steps of manuallyscanning barcodes to identify one or more of the patient, the caregiver,the medication, or the medical device, it is advantageous to provide anautomatic association of a patient with the medical device and amedication or other medical substance that are physically proximate tothem. Furthermore, the nurse who is also proximate to the patient can beidentified and associated with the medical device both for determiningthe allowable privileges in configuring the medical device and inrecording the administration of a medication. The combination ofassociating a medical device with a patient, a medication with thepatient and with the medical device, and the caregiver with all of theseelements provides an automatic way to verify the five rights ofmedication administration.

The disclosed method and system provides for the automatic associationof elements that are in or enter a single defined physical space. Theseelements include one or more of a patient, a medical device, amedication or medical substance, and a caregiver. The association ofthese elements enables the automatic configuration of the medical deviceto administer the medication to the patient as well as providing anautomatic record of the caregiver and the details of the administrationof the medication or medical substance.

A method of associating a plurality of objects is disclosed, wherein themethod comprises the steps of defining a physical space, determining byuse of a real time locating system (RTLS) what objects are within thephysical space, and associating the objects determined by the RTLS to bewithin the physical space, wherein the objects include at least one of acaregiver, a patient, a medical device, a medication, and a medicalsubstance.

A method of associating a plurality of objects is disclosed, wherein themethod comprises the steps of defining a physical space about a firstdevice, determining by use of a RTLS objects that are within thephysical space, and associating the objects within the physical spacewith the first device, wherein the objects include at least one of anoperator, a user, a second device, and a supply.

A system is disclosed that includes a RTLS transceiver coupled to aprocessor. The RTLS transceiver is configured to identify and locate oneor more objects having a RTLS tag and provide information comprising theidentification and location of the tagged objects. The processor isconfigured to define a physical space, receive the identification andlocation of the tagged objects, and associate objects that are withinthe physical space.

A computer-readable medium having computer-executable instructionsstored thereon for execution by a processor to perform a method ofassociating a plurality of objects is disclosed, wherein the methodcomprises defining a physical space about a first device, determining byuse of a RTLS what objects are within the physical space, andassociating the objects within the physical space with the first device,wherein the objects include at least one of an operator, a user, asecond device, and a supply.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are included to provide furtherunderstanding and are incorporated in and constitute a part of thisspecification, illustrate disclosed embodiments and together with thedescription serve to explain the principles of the disclosedembodiments. In the drawings:

FIG. 1 depicts an example hospital room where a patient is to receivetreatment according to certain aspects of this disclosure.

FIG. 2 is a plan view of the room of FIG. 1 showing the coverage of anexample RTLS system according to certain aspects of this disclosure.

FIG. 3A is a plan view similar to FIG. 2 where multiple caregivers arepresent within the defined physical space according to certain aspectsof the disclosure.

FIG. 3B is an exemplary display of an IV pump requesting selection ofone of the multiple caregivers present in FIG. 3B according to certainaspects of the disclosure.

FIG. 4 depicts a plan view of a room in which multiple patients arepresent within the defined physical space according to certain aspectsof the disclosure.

FIG. 5 depicts an embodiment wherein the proximity of the elements to beassociated is based on interaction of the individual RTLS tags accordingto certain aspects of the disclosure.

FIG. 6 is a block diagram of an example configuration of the RTLS andthe elements to be associated according to certain aspects of thedisclosure.

FIG. 7 is a flowchart depicting an exemplary process of associatingelements within a defined physical space according to certain aspects ofthe disclosure.

DETAILED DESCRIPTION

The disclosed methods and system provide for the automatic associationof elements that are determined to be within a defined physical space.These elements include one or more of a patient, a medical device, amedication or medical substance, and any nurse, doctor, or othercaregiver. Once these items are associated, one or more of the elementsmay be configured according to the association with other elements,privileges may be granted based on the identification of the caregiverpresent in the physical area, and records kept of actions and eventsthat occur wherein the records include the dedication of the patient,the medical equipment, the medication or medical substance, and theidentities of the caregiver or caregivers that are present in thedefined physical area.

In the following detailed description, numerous specific details are setforth to provide a full understanding of the present disclosure. It willbe apparent, however, to one ordinarily skilled in the art thatembodiments of the present disclosure may be practiced without some ofthe specific details. In other instances, well-known structures andtechniques have not been shown in detail so as not to obscure thedisclosure.

The method and system disclosed herein are presented in terms of theadministration of a medication as an IV fluid using an IV pump to apatient in a hospital. The method and system, however, are equallyapplicable to other medical settings such as an outpatient clinic and tononmedical applications where it is desirable to associate variouselements based on a common presence within a defined physical space.Nothing in this disclosure should be interpreted, unless specificallystated as such, to limit the application of any method or systemdisclosed herein to a medical or hospital environment.

FIG. 1 depicts an example hospital room 18 where a patient 10 is toreceive treatment according to certain aspects of this disclosure. Inthis example, a patient 10 is to receive an infusion of a medication 16using an IV pump 14, wherein this medication 16 is to be administered bya nurse 12. To ensure the safety of the patient, the nurse 12 mustverify that medication 16 has been prescribed for patient 10, ensurethat IV pump 14 is configured to deliver the medication 16 at theprescribed rate, and record all of the details of this medicationadministration in the patient's medication administration record (MAR).Performing these tasks takes time and careful attention and there isalways the risk, even with the most conscientious personnel, of making amistake or forgetting to record something in these manual processes.

FIG. 2 is a plan view of the room of FIG. 1 showing the coverage of anexample RTLS system according to certain aspects of this disclosure. ARTLS identifies objects and tracks the location of the objects in realtime using “tags” that are attached to or embedded in the objects. Thetags comprise wireless transmitters and the RTLS comprises at least onetransceiver that comprises at least one antenna to receive the wirelesssignals from the tags. The transceivers are connected to a centralcontroller, e.g. a part of the RTLS system 44 of FIG. 6, over, in somecases, a standard communication network such as a wired or wirelessEthernet network 50. The central controller comprises a processor thatcontrols the function of the transceivers and stores, e.g. in database44 of FIG. 6, the locations of all objects that have RTLS tags and arewithin the range of at least one transceiver. In some cases, thetransceivers communicate wirelessly between each other to form a meshnetwork that links to the central controller. The range of the antennaof each transceiver defines a physical space, e.g. the physical space 22of FIG. 2, such that an object is known to be within the physical spacewhen the transceiver are able to receive the wireless signal transmittedby the tag that is attached to the object. In some RTLS systems, thelocation of the object within the space can be further determined usingthe signal strength measured by the transceiver or, if the physicalspaces associated with multiple transceivers overlap, receipt of thetag's signal by multiple transceivers. RTLSs may be purchased fromcompanies such as the Awarepoint Corp. of San Diego, Calif., USA andCentrak of Newtown, Pa., USA.

RTLS tags may be generic, wherein all objects of a certain type havetags that are indistinguishable from each other, or specific, whereineach tag has a unique identifier that is part of the wireless signalbroadcast by the tag. For example, a tag that is attached to an IV pump14 may be programmed to either broadcast a code associated with all IVpumps (generic) or broadcast the serial number of that IV pump 14(specific). Similarly, a tag that is embedded in the identification (ID)badge of a nurse 12 may broadcast the ID number assigned to that nurse12 (specific). A tag that is attached to a medicine, for example, suchas an IV bag 16 containing a custom mixture of medications may broadcastthe unique serial number of that specific IV bag 16 (specific). Sometags broadcast a unique identifier that is associated with the tag,wherein the tag identifier is associated in the database 48 with theobject to which the tag is attached, the association of the tagidentifier with the object being made when the tag was attached to theobject. It will be apparent to those of ordinary skill in the art that aRTLS tag may be associated with the object to which the tag is attachedin many other ways.

RTLS tags typically broadcast their signal at intervals that may rangefrom a few seconds to a few minutes. When a tag first enters a physicalspace and the signal broadcast by the tag is detected by the transceiverassociated with that space, the presence of the object associated withthat tag in that physical space is recorded in the database. When a tagis no longer detected by the receiver associated with the physical spacein which it was previously detected, or when the tag is detected to bein a new physical space, the location information stored in the databaseis updated. Thus, the location of all objects that carry RTLS tags areknown on a near-real-time basis, wherein the latency, i.e. the delaybetween a change in location and the change being recorded in thedatabase, is determined in part by the time interval between broadcastsby the RTLS tags.

In the example of FIG. 2, a RTLS transceiver 20 is mounted on a wall 19of a patient room 18, wherein the RTLS transceiver 20 has a range thatdefines a physical space 22 (shown as the shaded region in FIG. 2)wherein the RTLS transceiver 20 is able to communicate with RTLS tags.The physical space covers a portion of the room 18 that includes thepatient bed 11. The range of the RTLS transceiver 20 is such that, inthis example, it does not extend out the door 18A. The patient 10,currently lying in bed 11, is wearing a RTLS tag 10A that is, in thisexample, part of his patient identification wristband. The nurse 12 iswearing a RTLS tag 12A as part of her ID badge. The IV pump 14 has aRTLS tag 14A attached to it. The IV bag of medication 16 also has a RTLStag 16A attached to it. All of the tags 10A, 12A, 14A, and 16A arewithin the defined physical space 22 in FIG. 2.

Multiple associations can be made of objects within the defined physicalspace 22. In this example, the patient was alone in the room 18 prior tothe arrival of the nurse 12 with the IV pump 14 and the medication 16.The defined physical space 22 was therefore first associated withpatient 10. When the nurse 12 arrived with the IV pump 14 and medication16, the IV pump 14 was associated with patient 10, the medication 16 wasassociated with both the patient 10 and the IV pump 14, and the nurse 12was associated with the IV pump 14 to enable the IV pump 14 to beconfigured according to the privileges assigned to nurse 12.

When an IV pump 14 has been associated with a patient 10, additionalsafeguards and automatic actions become possible. For example, if thepatient 10 who is associated with the IV pump 14 becomes separated fromthe IV pump 14, the nurse 12 assigned to the patient 10 can be notifiedto immediately check on the patient 10. Similarly, if a change in one ofthe operating parameters of the IV pump 14 occurs when no caregiver isproximate to the IV pump 14, the nurse 12 assigned to the patient 10 canbe notified to immediately check on the settings of the IV pump 14.

The detection and identification of all of the caregivers that arewithin the defined physical space 22 when an action occurs allowscertain actions to be taken without first requiring the caregiver to logonto the medical device 14. For example, conventional medical devicessometimes require the caregiver to type in their password or otherwiseidentify themselves prior to the caregiver being able to silence analarm. This is both time-consuming, at a time when the caregiver isfocused on correcting a condition for which the alarm sounded, andstressful, as it may be difficult to correctly type a password while analarm is sounding at close range. The disclosed system overcomes thesedifficulties by enabling the alarm to be canceled when a caregiver 12 iswithin the same defined physical space 22 as the medical device 14. Incertain embodiments, the caregiver 12 can walk into a room 18 and, asthe caregiver 12 will be associated with the medical device 14 by thetime the caregiver 12 reaches the medical device 14, the caregiver 12may simply press the button on the medical device 14 to deactivate thealarm without any preliminary action.

FIG. 3A is a plan view similar to FIG. 2 where multiple caregivers arepresent within the defined physical space according to certain aspectsof the disclosure. In this example, the patient 10 and nurse 12 havebeen joined in room 18 by doctors 24 and 26. The nurse 12 and doctors24,26 are all standing within the defined physical space 22. In thisexample, the doctors 24,26 have been assigned privileges related to theIV pump 14 that are greater than the privileges assigned to nurse 12.For example, the doctors 24,26 may be assigned the privilege of settingthe flow rate outside of the standard boundaries defined in the hospitalprotocols, while the nurse 12 may only set the flow rate to a valuewithin the standard boundaries. In this example, the IV pump 14 has beenenabled to accept operating parameters according to the highestprivileges of the three caregivers 12, 24, 26 who are within the definedphysical space 22. A record will be created that includes theidentification of all caregivers 12, 24, 26 who are within the definedphysical space 22 at the time the operating parameters were adjusted orother events occur. Although the identities of the caregivers 12, 24, 26are recorded by the disclosed system, it is not recorded by the systemwhich of the caregivers 12, 24, 26 took the action. What is noted is thepresence of the caregivers 12, 24, 26 in the defined space 22 when theaction was taken. In certain embodiments, a caregiver 12 must log intothe IV pump 14 before the IV pump 14 will accept operating parameters,and then will accept operating parameters according to the privileges ofthe logged-in caregiver 12. The record will include the identificationof at least the logged-in caregiver 12. In certain other embodiments, acaregiver 12 must simply identify themselves from a list of thecaregivers 12, 24, 26 that are currently within the defined space 22.

FIG. 3B is an exemplary display of an IV pump 14 requesting selection ofone of the multiple caregivers 12, 24, 26 present in FIG. 3B accordingto certain aspects of the disclosure. The IV pump is coupled, in thisexample, through a wired or wireless communication link, e.g.communication link 52 of FIG. 6, to a server 46 (not shown in FIG. 3B)that is coupled to the RTLS system 44 (not shown in FIG. 3B) asdiscussed in more detail in FIG. 6. In this example, it is necessary toidentify a specific clinician who has taken an action for the purpose ofrecord-keeping. To this end, a message is sent from the server 46 to theIV pump 14 containing the identification of the caregivers 12, 24, 26who have been detected to be within the physical space 22. The exampleIV pump 14 shown in FIG. 3B comprises a graphic display 14B and a seriesof buttons 14C on each side of the display 14B. A list of the threeclinicians 12, 24, 26 is presented on the display 14B, as shown withinthe broken-line oval 60. The display 14B also presents an instructionalmessage as shown within the broken-line oval 62. The clinician to beidentified is selected by pressing the button 14C that is next to theirname. This selection is transmitted back to the server 46 and stored inthe database 48. In certain embodiments, the server verifies that thepatient has a prescription comprising the medication; and downloadsconfiguration information to the medical device according to theprescription. In certain embodiments, a list of medications is presentedwhen more than one medication 16 is determined to be within the definedphysical space 22. In certain embodiments, a list of procedures orprescriptions is presented when more than one prescription has beenfound in the database associated with medication 16 and patient 10 andnot already associated with a device. In certain embodiments, operatingparameters that are associated with a procedure that has been orderedfor the patient are downloaded from the database. In certainembodiments, data records that are associated with a procedure that hasbeen performed for the patient are uploaded from the medical device tothe database.

FIG. 4 depicts an example wherein multiple patients 10 and 28 arepresent within the defined physical space 22 according to certainaspects of the disclosure. In this example, hospital room 18 is sharedby two patients 10 and 28 who are wearing RTLS tags 10A and 28A,respectively. Similar to the example of FIGS. 1 and 2, nurse 12 ispreparing to administer medication 16 to patient 10 using IV pump 14.Both patient 10 and patient 28 and their RTLS tags 10A and 28A, however,are within the defined physical space 22. It is not possible todetermine solely from their presence within defined physical space 22which patient is to receive the medication 16. In this example, however,there is a prescription for the administration of medication 16 topatient 10 while there is no such prescription for administration ofmedication 16 to patient 28. Medication 16 has therefore been associatedwith patient 10. This association is presented on the display of IV pump14 for verification by the nurse 12. In certain embodiments, the nurse12 is presented with a display on IV pump 14 of the names of the twopatients 10 and 28, similar to the presentation of the names of themultiple clinicians 12, 24, 26 on the IV pump 14 in FIG. 3B, and thenurse 12 chooses the name of the patient 10 who will receive themedication 16. It is faster and less susceptible to error to select froma short list of patients rather than search the entire roster ofpatients in the hospital. In certain embodiments, the patient 10 remainsassociated with IV pump 14 until the IV pump 14 is reassigned or anotherspecified event occurs, such as a discharge of the patient, that hasbeen defined to break the association of the IV pump 14 and the patient10.

FIG. 5 depicts an embodiment wherein the proximity of the elements to beassociated is based on interaction of the individual RTLS tags accordingto certain aspects of the disclosure. In this example, the RTLS tagsinteract among themselves to determine what elements are within closeproximity of each other. Each tag has a limited range. For example, theRTLS tag 10A worn by patient 10 has a range indicated by the broken linecircle 10B. Similarly, RTLS tag 12A worn by nurse 12 has a range 12B,RTLS tag 14A on IV pump 14 has a range of 14B, and RTLS tag 16A attachedto medication 16 has a range 16B. It can be seen that these four rangesoverlap within the area 30 indicated by the thicker dot-dash line.Associations are made between elements within this common area 30enabling certain actions, such as IV pump 14 retrieving the privilegesof nurse 12 based solely on their proximity and prior to any action bynurse 12. Similarly, the proximity of medication 16 and patient 10triggers the retrieval of any prescription for patient 10 that includesthe administration of medication 16.

FIG. 6 is a block diagram of an example configuration of the RTLS andthe elements to be associated according to certain aspects of thedisclosure. In this example, an association system 45 has been createdcomprising a RTLS system 44 and a server 46. The server 46 includes adatabase 48 that contains information about medications prescribed forpatients in the hospital, the privileges of the staff within thehospital, and operating parameters for medical devices within thehospital. In this example, the defined physical space 22 contains onepatient 10 wearing a RTLS tag 10A, a caregiver 12 wearing a RTLS tag12A, a medical device 40 having an attached RTLS tag 40A, and amedication 42 having an attached RTLS tag 42A. This physical space 22may be a fixed location, such as the interior of a hospital room, or maybe a dynamic area surrounding a specific device. For example, a physicalspace 22 may be defined as centered on the current location of medicaldevice 40, wherein the defined physical space 22 moves with the medicaldevice 40. The medical device 40 may be any device used to diagnose ortreat the patient 10 that is also within the defined physical space 22,such as an electrocardiogram (EKG) measurement system, a ventilator, ora simple ear thermometer, as well as an IV pump 14 as shown in theprevious figures. The medication 42, presented in the earlier examplesas a medical fluid, may be any type of medication including oral solids,ointments, or a gas such as oxygen. A RTLS tag present within definedphysical space 22 communicates wirelessly with the RTLS system 44 suchthat the RTLS system 44 determines that the object having an attachedRTLS tag, wherein the RTLS tag has been previously associated with theobject, is within the defined physical space 22. The RTLS system 44communicates with server 46 over a data link 50 such as an Ethernetnetwork. Server 46 is also connected, in this example directly tomedical device 40 over a data link 52, which may be the same Ethernetnetwork as data link 50 or a separate wired or wireless network ordirect connection allowing server 46 to communicate with medical device40. Server 46 can, for example, download operational parameters fromdatabase 48 to medical device 40 and receive information from medicaldevice 40 regarding caregivers that are in proximity to medical device40 when certain actions or events occurred. Server 46 is also connectedto other systems through an internal and/or external network shown as a“cloud” 99. The other systems may include the hospital'sAdmit/Discharge/Transfer (ADT) system, a MAR system, a billing system,and portable devices carried by the doctors or nurses. The connection ofthe RTLS system 44 to the server 46 may be over the Internet or othernetworks, for example.

FIG. 7 is a flowchart depicting an exemplary process of associatingelements within a defined physical space according to certain aspects ofthe disclosure. The process starts in step 105 wherein a physical spaceis defined. This physical space may be a fixed area or may be a dynamicarea linked to an object such as a medical device. Once a physical spaceis defined, the process proceeds to determine whether one or more of apatient, a medical device, a caregiver, or a medication or medicalsubstance is present within the defined physical space in steps 110,115, 120, 125, and 130. If multiple caregivers are present within thedefined physical space and it is necessary to identify the specificcaregiver, for example, when the hospital protocol requires theidentification of the individual performing a specific action or as partof a medication administration record, a list of the caregivers locatedwithin the defined physical space is presented on, for example, adisplay of the medical device, a computer terminal located in the room,or a portable device carried by one of the caregivers in step 135. Thename of the specific individual can be selected in step 140 by one ofthe caregivers using the same device that displays the list. In step145, the privileges associated with all of the caregivers that arepresent within the defined physical space are retrieved and the medicaldevice is configured to accept input based on the highest privileges ofany of the caregivers that are present within the defined physicalspace. In certain embodiments, the caregiver wishing to configure themedical device must identify himself or herself such as by entering apassword whereupon the medical device is configured to accept inputbased on the privileges of that logged-in caregiver. If multiplepatients are present within the defined physical space and it isnecessary to identify the specific patient, for example when amedication is to be administered, then a list of patients within thedefined physical space is presented (on the same device as used in step135) in step 150 and the patient is selected by one of the caregivers instep 155. Other similar sets of steps (not shown) are used to identify aspecific medical device when multiple medical devices are present withinthe defined physical space and to identify a specific medication whenmultiple medications are present within the defined physical space. Oncea medical device and a specific patient have been identified, theprocess proceeds to step 160 wherein the medical device is associatedwith the patient.

Once the medical device is associated with the patient in step 160,configuration information is retrieved from the database in step 165,wherein the configuration information is associated with at least one ofthe medication and the medical device that have been determined to bewithin the defined physical space. In certain embodiments thisconfiguration information includes the operating parameters for themedical device which are downloaded into the medical device directly. Instep 170, the caregiver configures the medical device including physicalconfiguration such as connecting an IV set to a source of medical fluidand to the patient and to the medical device as well as adjustingoperating parameters of the medical device. In step 175, theconfiguration and settings and the identification of all of thecaregivers that have been determined to be within the defined physicalspace are recorded in the patient's MAR. In step 180, the medical deviceis activated and the administration of the medication is initiated. Theprocess stays in step 180 for the duration of the administration ofmedication and the system records a specified list of events and actionsalong with the identification of caregivers that are determined to bewithin the defined physical space at the time the events occur. When theadministration of the medication is complete, the process ends.

In summary, the disclosed method and system of associating one or moreof a patient, a medical device, a caregiver, and a medication or medicalsubstance provides increased patient safety as well as reducing theworkload of the caregiver by implementing configuration changes ordocumentation tht otherwise would be manually accomplished. Theautomatic association of a patient with a medication when the medicationis brought into a defined physical space around the patient and enablesthe automatic verification that this is the right patient, the rightmedication, and the right time, covering three of the “five rights” ofmedication administration. Automatic association of a medical device,such as an IV pump, with a patient facilitates the verification thatthis is the right route of administration and enables the automaticdownload of the operating parameters for the medical device, ensuringthat the right dose is administered, addressing the remaining two of the“five rights.” The automatic association of the caregiver with themedical device enables the automatic logging of events along with theidentification of the caregivers that are present, thus reducing theworkload of the caregivers. Furthermore, the automatic logging providesthe facility with greater data for analysis and improved record-keepingand documentation of actual patient care.

The previous description is provided to enable a person of ordinaryskill in the art to practice the various aspects described herein. Whilethe foregoing has described what are considered to be the best modeand/or other examples, it is understood that various modifications tothese aspects will be readily apparent to those skilled in the art, andthe generic principles defined herein may be applied to other aspects.Thus, the claims are not intended to be limited to the aspects shownherein, but is to be accorded the full scope consistent with thelanguage claims, wherein reference to an element in the singular is notintended to mean “one and only one” unless specifically so stated, butrather “one or more.” Unless specifically stated otherwise, the terms “aset” and “some” refer to one or more. Pronouns in the masculine (e.g.,his) include the feminine and neuter gender (e.g., her and its) and viceversa. Headings and subheadings, if any, are used for convenience onlyand do not limit the invention.

It is understood that the specific order or hierarchy of steps in theprocesses disclosed is an illustration of exemplary approaches. Basedupon design preferences, it is understood that the specific order orhierarchy of steps in the processes may be rearranged. Some of the stepsmay be performed simultaneously. The accompanying method claims presentelements of the various steps in a sample order, and are not meant to belimited to the specific order or hierarchy presented.

Terms such as “top,” “bottom,” “front,” “rear” and the like as used inthis disclosure should be understood as referring to an arbitrary frameof reference, rather than to the ordinary gravitational frame ofreference. Thus, a top surface, a bottom surface, a front surface, and arear surface may extend upwardly, downwardly, diagonally, orhorizontally in a gravitational frame of reference.

A phrase such as an “aspect” does not imply that such aspect isessential to the subject technology or that such aspect applies to allconfigurations of the subject technology. A disclosure relating to anaspect may apply to all configurations, or one or more configurations. Aphrase such as an aspect may refer to one or more aspects and viceversa. A phrase such as an “embodiment” does not imply that suchembodiment is essential to the subject technology or that suchembodiment applies to all configurations of the subject technology. Adisclosure relating to an embodiment may apply to all embodiments, orone or more embodiments. A phrase such an embodiment may refer to one ormore embodiments and vice versa.

The word “exemplary” is used herein to mean “serving as an example orillustration.” Any aspect or design described herein as “exemplary” isnot necessarily to be construed as preferred or advantageous over otheraspects or designs.

All structural and functional equivalents to the elements of the variousaspects described throughout this disclosure that are known or latercome to be known to those of ordinary skill in the art are expresslyincorporated herein by reference and are intended to be encompassed bythe claims. Moreover, nothing disclosed herein is intended to bededicated to the public regardless of whether such disclosure isexplicitly recited in the claims. No claim element is to be construedunder the provisions of 35U.S.C. §112, sixth paragraph, unless theelement is expressly recited using the phrase “means for” or, in thecase of a method claim, the element is recited using the phrase “stepfor.” Furthermore, to the extent that the term “include,” “have,” or thelike is used in the description or the claims, such term is intended tobe inclusive in a manner similar to the term “comprise” as “comprise” isinterpreted when employed as a transitional word in a claim.

1. A method of associating a plurality of objects, the method comprisingthe steps of: defining a physical space; determining by use of areal-time locating system (RTLS) objects that are within the physicalspace; and associating the objects determined by the RTLS to be withinthe physical space, wherein the objects include at least one of acaregiver, a patient, a medical device, a medication, and a medicalsubstance.
 2. The method of claim 1, further comprising the steps of:determining that a patient is within the physical space; determiningthat a medical device is within the physical space; associating themedical device with the patient; and recording the assignment of themedical device to the patient in a database.
 3. The method of claim 2,further comprising the step of downloading one or more operatingparameters to the medical device from a database, wherein the operatingparameters are associated with a procedure that has been ordered for thepatient.
 4. The method of claim 2, further comprising the step ofuploading one or more data records from the medical device to adatabase, wherein the data records are associated with a procedure thathas been performed for the patient.
 5. The method of claim 4, furthercomprising the step of uploading one or more data records to an externalsystem that comprises at least one of a Admit/Discharge/Transfer (ADT)system, a Medication Administration Record (MAR) system, a billingsystem, and a portable device carried by a doctor or a nurse.
 6. Themethod of claim 2, further comprising the steps of determining that morethan one patient is within the physical space; determining a caregiverthat is within the physical space; presenting the identifications of thepatients to the caregiver; and accepting a selection from the caregiverof the patient with whom the medical device is to be associated.
 7. Themethod of claim 2, further comprising the steps of: determining that acaregiver is within the physical space; and allowing access to themedical device only when a caregiver is within the physical space. 8.The method of claim 7, further comprising the step of controlling accessto the medical device according to privileges associated with themedical device assigned to the caregiver.
 9. The method of claim 8,wherein the access to the medical device is controlled according to thehighest privileges of the caregivers when more than one caregiver iswithin the physical space.
 10. The method of claim 2, further comprisingthe steps of: identifying actions or events related to the medicaldevice; identifying one or more caregivers that are within the physicalspace when the action or event occurred; and recording the action orevent and the identities of the caregivers.
 11. The method of claim 2,further comprising the steps of: identifying a medication that is withinthe physical space; and configuring the medical device to be used withthe medication.
 12. The method of claim 11, further comprising the stepsof: verifying that the patient has a prescription comprising themedication; and configuring the medical device according to theprescription.
 13. The method of claim 12, further comprising the stepsof: presenting the identifications of the patients to the caregiver whenmore than one patient is in the physical space; and accepting aselection from the caregiver of the identification of the patient withwhom the first medical device is to be associated.
 14. The method ofclaim 11, further comprising the step of recording the identification ofthe patient, the identification of the caregiver, and the identificationof the medication when the first medical device is activated.
 15. Amethod of associating a plurality of objects, the method comprising thesteps of: defining a physical space about a first device; determining,by use of a RTLS, objects that are within the physical space; andassociating the objects within the physical space with the first device,wherein the objects include at least one of an operator, a user, asecond device, and a supply.
 16. A system comprising: a RTLS transceiverconfigured to define a physical space and identify objects comprisingRTLS tags that are within the physical space; and a processor coupled tothe RTLS transceiver, the processor configured to receive theidentification of the tagged objects and associate one or more of theobjects, wherein the objects include at least one of a caregiver, apatient, a medical device, a medication, and a medical substance. 17.The system of claim 16, further comprising a database coupled to theprocessor, the database configured to store data, wherein the processoris further configured to store associations of objects in the database.18. The system of claim 17, wherein the processor is further configuredto associate a medical device identified by the RTLS transceiver to bewithin the physical space with a patient identified by the RTLStransceiver to be within the physical space and record this associationin the database.
 19. The system of claim 18, wherein the databasecomprises at least one prescription for the patient identified by theRTLS transceiver to be within the physical space, wherein theprescription comprises one or more operating parameters associated withthe medical device associated with the patient, and wherein theprocessor is configured to retrieve the operating parameters from theprescription and download the operating parameters to the medicaldevice.
 20. The system of claim 19, wherein the processor is furtherconfigured to associate a medication identified by the RTLS transceiverto be within the physical space with the medical device, identify aprescription in the database that comprises the medication, and retrievethe operating parameters from the identified prescription.
 21. Thesystem of claim 18, wherein the processor is configured to upload one ormore data records associated with a procedure that has been performedfor the patient from the medical device and to store the data records inthe database.
 22. The system of claim 21, wherein the processor isconfigured to upload one or more data records to an external system thatcomprises at least one of a Admit/Discharge/Transfer (ADT) system, aMedication Administration Record (MAR) system, a billing system, and aportable device carried by a doctor or a nurse.
 23. The system of claim18, wherein the processor is further configured to present theidentifications of one or more patients identified by the RTLStransceiver to be within the physical space to a caregiver identified bythe RTLS transceiver to be within the physical space and to accept aselection from the caregiver of the patient with whom the medical deviceis to be associated.
 24. The system of claim 18, wherein the processoris further configured to control the medical device to allow accessaccording to whether a caregiver identified by the RTLS transceiver tobe within the physical space.
 25. The system of claim 24, wherein theprocessor is further configured to control the medical device to allowaccess according to the highest privileges of the caregivers within thephysical space when more than one caregiver is identified by the RTLStransceiver to be within the physical space, wherein each caregiver hasbeen assigned one or more privileges associated with the medical device.26. The system of claim 17, wherein the processor is further configuredto store in the database a data record of actions and events associatedwith the medical device with the identification of all caregiversidentified by the RTLS transceiver to be within the physical space atthe time of the action or event.
 27. A computer-readable medium havingcomputer-executable instructions stored thereon for execution by aprocessor to perform a method of associating a plurality of objects, themethod comprising: defining a physical space; determining, by use of aRTLS, objects that are within the physical space; and associating theobjects determined by the RTLS to be within the physical space, whereinthe objects include at least one of a caregiver, a patient, a medicaldevice, a medication, and a medical substance.
 28. The computer-readablemedium of claim 27, wherein the method further comprises the steps of:determining that a patient is within the physical space; determiningthat a medical device is within the physical space; associating themedical device with the patient; and recording the assignment of themedical device to the patient in a database.
 29. The computer-readablemedium of claim 28, wherein the method further comprises the step ofdownloading one or more operating parameters to the medical device froma database, wherein the operating parameters are associated with aprocedure that has been ordered for the patient.
 30. Thecomputer-readable medium of claim 28, wherein the method furthercomprises the step of uploading one or more data records from themedical device to a database, wherein the data records are associatedwith a procedure that has been performed for the patient.
 31. Thecomputer-readable medium of claim 28, wherein the method furthercomprises the steps of: determining that one or more patients are withinthe physical space; determining a caregiver that is within the physicalspace; presenting the identifications of the patients to the caregiver;and accepting a selection from the caregiver of the patient with whomthe medical device is to be associated.
 32. The computer-readable mediumof claim 28, wherein the method further comprises the steps of:determining that a caregiver is within the physical space; and allowingaccess to the medical device only when a caregiver is within thephysical space.
 33. The computer-readable medium of claim 32, whereinthe method further comprises the steps of: identifying at least onecaregiver that is within the physical space, each caregiver having oneor more privileges associated with the medical device; and controllingaccess to the medical device according to the privileges of thecaregivers within the physical space.
 34. The computer-readable mediumof claim 33, wherein the access to the medical device is controlledaccording to the highest privileges of any caregiver that is within thephysical space when more than one caregiver is within the physicalspace.
 35. The computer-readable medium of claim 28, wherein the methodfurther comprises the steps of: identifying actions or events related tothe medical device; identifying one or more caregivers that are withinthe physical space when the action or event occurred; and recording theaction or event and the identities of the caregivers.
 36. Thecomputer-readable medium of claim 28, wherein the method furthercomprises the steps of: identifying a medication that is within thephysical space; and configuring the medical device to be used with themedication.
 37. The computer-readable medium of claim 36, wherein themethod further comprises the steps of: verifying that the patient has aprescription comprising the medication; and configuring the medicaldevice according to the prescription.
 38. The computer-readable mediumof claim 36, wherein the method further comprises the step of recordingthe identification of the patient, the identification of the caregiver,and the identification of the medication when the first medical deviceis activated.